On July 19, Professor Zhao Ren led a surgical team at Ruijin Hospital to successfully complete the first fully single-port laparoscopic robot-assisted radical gastrectomy for distal gastric cancer (Billroth I anastomosis). No similar surgery has been reported in the news or literature worldwide by press time. The surgery is not only the first of its kind completed by fully using a robot but also the first one performed using a Chinese-developed single-port robot.
After a comprehensive evaluation of surgical robots and the 69-year-old patient, Zhang Bo (pseudonym), with gastric cancer, Professor Zhao Ren and his team decided to perform surgery with a Chinese-developed robot. During the surgery, Professor Zhao Ren’s team used Shurui’s snake-like surgical instrument for large-angle flexible bending to precisely mobilize the right gastroepiploic artery and vein, the right gastric artery and vein and the duodenum and severe the duodenum with a stapler. Then, the team mobilized and ligated the left gastric artery and vein and mobilized lesser and greater curvatures of the stomach. With the third support arm’s sufficient traction and tension, the team ensured the identification of layers and reduced bleeding; the team performed distal gastrectomy after confirming the resection margin; then, the team punched holes in the gastric stump and the duodenum and put in a stapler to perform side-to-side anastomosis; finally, the team sutured and closed the anastomotic stoma and reinforced the duodenal stump. The surgery was successfully completed with small bleeding during the process and a small incision of only 4 cm on the body surface.
With proficiency in the operation of the Chinese-developed single-port surgical robot, rich surgical experience and smooth cooperation, Professor Zhao Ren’s team overcame the challenges and difficulties posed by new technology and equipment, explored new models and plans for single-port robot surgery and achieved a breakthrough in radical gastrectomy for distal gastric cancer by transitioning from multi-port robot surgery to single-port robot surgery. The successful completion of the surgery marks a milestone in the field of general surgery for Chinese-developed single-port surgical robots, signifies that Chinese-developed surgical robots are continuously expanding their application areas with their technological advantages and will popularize surgical techniques that reduce incision sizes and trauma and bring faster recovery.
“The application of multi-port robots in SILS (single-incision laparoscopic surgery) has many limitations such as restricted internal and external instrument movement and external instrument collisions,” said Professor Zhao Ren. “Single-port robots overcome the technical difficulties of SILS. In addition to robotic systems’ enlarged 3D vision, flexible surgical instruments and hand tremor filtration, Shurui’s single-port laparoscopic surgical robot’s positioning arms can co-move safely and continuously adjust positions during surgery to meet the requirements for coverage of the surgical area. Further, the snake-like surgical instrument adopts the unique dual continuum mechanism technology, with characteristics including big operation space, strong load-bearing capacity and high reliability, to meet high-precision operation requirements during surgery. However, single-port laparoscopic radical gastrectomy for distal gastric cancer involves multiple steps and is challenging.”
Reduced trauma and better effects have been a common and genuine desire of patients for surgical treatment. The Department of General Surgery at Ruijin Hospital actively practices the concepts of minimally invasive and precision surgery and continuously explores surgical innovation to popularize advanced technologies, benefit patients and promote progress in surgical technologies in China and the world.
Source: Ruijin Hospital, Shanghai Jiao Tong University School of Medicine